Awareness of Academic Staff Physicians with Principles of Evidence-Based Medicine and its Application in Daily Practice

Introduction: The purpose of this study was to evaluate familiarity of academic staff physicians with EBM and its application in daily practice. Methods: This cross-sectional study was conducted in 2022 with the participation of academic staff physicians of Hamadan University of Medical Sciences in Iran. Data were collected using CEBM questionnaire and were analyzed with SPSS 20 software, using T-test and Spearman correlation statistical tests. Results: Out of 156 academic physicians, 97 (62.2%) completed the questionnaire, 62 (63.9%) were male, and 33 (34%) had participated in EBM workshops. Mean score of knowledge and attitude questions were 14.7± 3.9 and 3.8± 0.5 respectively. There was no significant difference between males and females in knowledge and attitudes (P >0.05). Physicians who participated in EBM workshops had higher scores in knowledge (P <0.05) but not in attitude (P= 0.06). Positive and significant correlation between age (r = 0.32, P = 0.001) and teaching experience (r = 0.28, P = 0.005) was observed with knowledge and attitude about EBM. 69.1% of participants used very little or not at all EBM in their daily practice. The most important obstacles were lack of time (49.5%) and specific information (22.7%). More than 65% of physicians tended to use EBM in their daily practice. Conclusion: The academic staff physicians of Hamadan, Iran had a positive attitude towards evidence-based medicine, but did not have enough information in this regard. Accordingly, its application in daily clinical work was relatively low. Holding EBM workshops is essential to increase awareness about EBM

Late cardiac perconditioning by phenylephrine in an isolated rat heart model is mediated by mitochondrial potassium channels

The present study was designed to investigate the effect of early and late administration of phenylephrine during ischemia against regional ischemia–reperfusion injuries in an isolated rat heart model. All animals were randomly divided into experimental groups: (I) IR (Ischemic/ reperfusion): the hearts underwent 35 min of regional ischemia followed by 60 min of reperfusion; (II) 5HD-IR-0: the hearts were perfused for 5 min with 5HD (5-hydroxydecanoate, specific mKATP channel blocker, 100 µM) at the onset of regional ischemia; (III) 5HD-IR-20: the hearts were perfused for 5 min with 5HD 20 min after regional ischemia; (IV) PE-IR-10: the hearts were perfused for 5 min with phenylephrine 10 min after regional ischemia; (V) PE-IR-30: the hearts were perfused for 5 min with phenylephrine (100 µM) 30 min after regional ischemia; (VI) PE-5HD-IR-10 group: the hearts were perfused for 5 min with 5HD at the onset of regional ischemia after which phenylephrine was administrated as in group IV; and (VII) PE-5HD-IR-30: the hearts were perfused for 5 min with 5HD 20 min after the ischemia and then phenylephrine was administrated as in group V. The hemodynamic parameters were recorded throughout the experiment. Ischemia-induced arrhythmias, myocardial infarct size (IS), creatin kinase-MB isoenzyme (CK-MB), plasma lactate dehydrogenase (LDH) activities, and coronary blood flow (CBF) were measured in all animals. Perfusion of phenylephrine 30 min after the regional ischemia curtailed the myocardial infarct size, reduced CK-MB, and improved cardiac function and CBF. Administration of 5HD 30 min after the ischemia abolished cardioprotective effects of phenylephrine in the late phase. These results suggest the involvement of mKATP in the mechanism of phenylephrine-induced late preconditioning

Effects of hydro-alcoholic extract of rosa damascena mill leaf on smooth muscle contractions

BACKGROUND AND OBJECTIVE: Rosa damascena Mill is from Rosacea family which has been used in traditional medicine for the treatment of gastrointestinal diseases. The effects of petal’s hydro-alcoholic extract of Rosa damascena Mill were examined on the trachea, aorta and uterus of Wistar rats in this study. METHODS: This experimental study was conducted on forty male Wistar rats randomly divided into five groups of eight including control group, the groups receiving 0.5, 0.75 and 1 doses of Rosa damascena Mill extract with the presence and absence of calcium chloride. Isometric contraction was recorded by adding KCl to smooth muscle with stability device. After reaching the pan state, the effects of saline and cumulative concentrations of extracts were recorded and the percentage changes were calculated. FINDINGS: Cumulative extract of Rosa damascena Mill (0.5, 0.75 and 1ig/m) dependent on dose caused the rat’s trachea, aorta and uterus contractions (p<0.05). The contractions of cumulative extract of Rosa damascena Mill were 54+ 2/37, 96+3/32 and 62+2/17 in aortic smooth muscle, trachea and uterus, respectively with the presence of 60mM calcium chloride. CONCLUSION: The results of this study showed that Rosa damascena Mill increased the trachea, aorta and uterus contractions. Therefore it should be used with caution in patients suffering from asthma, dysmenorrhea or hypertension. © 2014, Babol University of Medical Sciences. All rights reserved

The teratogenic and abortifacient effects of heracleum persicum hydroalcholic extract and its correlation with mothers’ estrogen and progesterone in Balb/C mice

BACKGROUND AND OBJECTIVE: Heracleumpersicum is an Iranian medicinal plant which is used for various diseases. However, there is no scientific evidence to prove its side effects in pregnancy. Therefore, this study was designed to evaluate the teratogenic and abortifacient effects of Heracleum persicum hydroalcholic extract in Balb/c mice. METHODS: In this experimental study, 30 Balb/c mice were randomly divided into 3 groups, after mating and vagina platelets observation. First group received nothing, and second group received distilled water (gavage) and the third roup received 12.5 mg/kg/day Heracleum persicum hydroalcholic extract for 7 days. In 18-19th day of the experiment, caesarean surgery was done and embryos were collected in normal saline. The embryos weight and heights were measured and any defects in skeleton or other observable defects in other parts were evaluated. Estrogen and progesterone levels were also measured to evaluate the mechanisms. FINDINGS: There was a significant difference in estrogen percentage (13.82±9.09ng/ml in case group vs. 2.4±0.4ng/ml in control group) and in progesterone percentage (24.56±18.5ng/ml in case group vs. 52.46±1.35ng/ml in control group) between two groups (p<0.05). The abortifacient effect of the plant was supported by the changes in blood estrogen and progesterone. The percentage of abortifacient was 0.55±0.14 in plant group and zero in control group. There was no significant difference in studied groups regarding embryos heights. However, the embryos weights were less in case group (p<0.05). CONCLUSION: Considering plant effect on weight and hormone changes in pregnancy and abortifacient effect of Heracleum persicum in experimental group, its consumption should be with cautious during pregnancy. © 2014, Babol University of Medical Sciences. All rights reserved

Antioxidant Activity and Teratogenicity Evaluation of Lawsonia Inermis in BALB/c Mice.

BACKGROUND AND AIM Lawsonia inermis is a medicinal plant with abortive properties. There has been no scientific study to evaluate the teratogenicity of this plant. This study was performed to determine the antioxidant activity and the possible side effect of L. inermis hydroalcoholic extract on development of congenital abnormalities in BALB/c mice. MATERIALS AND METHODS In this experimental study, 120 female mature BALB/c mice were assigned to four groups and after mating and confirming the vaginal plug, the animals in the first group (G1) were kept with no intervention, and the second (G2), third (G3) and fourth (G4) groups were intraperitoneally (ip) injected with respectively saline (0.3 ml), and 10 and 100 mg/kg of L. inermis extract (for 7 days). On the 19th day, caesarean section was performed on the mice and embryos were examined for abnormalities. Their height and weight were measured. Data were analysed by ANOVA and post-hoc least significant difference tests. RESULTS There were significant differences between G3 and G4, and G1 (p<0.001); no significant difference was seen between G3 and G4. At 100 mg/kg dose of L. inermis, the parietal bones were absent in 90% of embryos and more extra ribs were observed in both G3 and G4 (p = 0.01). CONCLUSION L. inermis may have teratogenicity and should be used cautiously during pregnancy

An Overview of Angiogenesis and Chemical and Physiological Angiogenic Factors: Short Review

Angiogenesis refers to the formation of new blood vessels from existing ones, which can occur in both physiologic and pathologic conditions. Lack of tissue oxygen is the main stimulator of angiogenesis accompanied by increasing in HIF-1α-(hypoxia-inducible factor-1α) expression as a nuclear transcription factor. Other factors such as VEGF (vascular endothelial growth factor), FGF2 (fibroblast growth factor2), and TGF (transforming growth factor) are involved in angiogenesis, too. To control diabetes and tumoral disease, abnormal angiogenesis inhibition can be useful besides stimulation that can be helpful in cardiovascular disease. In this study, we have reviewed the mechanisms and stimulators of angiogenesis and its influential factors. The most important angiogenic factors are MMP, Ang, FGF, and VEGF. Ang is not directly involved in the process of angiogenesis but sometimes destabilize the arteries. In contrast to angiostatin, endostatin TIMP and TSP1 act as the most important angiostatic factors. Many attempts have been made to identify the mechanisms and factors involved in this process but angiogenic inhibitors that inhibit the growth of cancerous masses or tumors in the body have not yet been adequately investigate

A Comprehensive Review on Diabetes Mellitus and Its Relation to Other Diseases

Introduction: The prevalence of type 1 and type 2 diabetes is rising worldwide. Diabetes is a major health issue across the globe and a cause of microvascular and macrovascular complications, including nephropathy, neuropathy, retinopathy, blindness, and cardiovascular disease. Long-term control of blood glucose is an important and determining factor in the prevention of these complications. Methods: In this review study, the databases such as Scientific Information Database, PubMed, SID, ISI, and Scopus were searched for articles published from 1975 to 2019, with emphasis on the articles published within the past 10 years. The used keywords were diabetes, insulin, oxidative stress, microvascular, and macrovascular as well as the diseases and disorders related to diabetes. Results: Considering diabetes, types of diabetes, and its relationship with the organs, it is possible to estimate some degree of prevention, recovery, and timely treatment of diabetes and its effects on other organs Conclusion: Diabetes mellitus (DM) causes numerous diseases and affects the organs due to hyperglycemia, reduced insulin level or insulin tolerance, increased free radicals, and dysfunction of organs. Delay in the diagnosis of diabetes leads to increased diabetes complications that can be prevented by severe glycemic control

A Review on the Most Important Medicinal Plants Effective in Cardiac Ischemia-Reperfusion Injury

Ischemia, referring to reduction and restriction of perfusion to myocardial tissue which involves coronary artery through the formation of misplaced clots and thrombosis, is one of the most important cardiovascular diseases. Plant-based compounds help to improve or prevent disease by affecting the factors involved in the disease. This review was conducted to report the medicinal plants and factors effective in cardiac ischemia-reperfusion (UR) injury to supplement the knowledge about this disease and its prevention and treatment using certain medicinal plants and their active compounds. For this purpose, medicinal plants and their potential antioxidant activities, effects on lipid levels and plaque formation, atherosclerosis and development of cardiovascular diseases and ischemia were reviewed. Methods: To conduct this review, relevant articles published between 1983 and 2018 were retrieved from the Google Scholar, PubMed, Scientific Information Database, Web of Science, and Scopus using search terms antioxidant, ischemia, reperfusion, heart, infarct, inflammation, cholesterol and medicinal plants. Then, the eligible articles were reviewed. Results: The active compounds of plants, including phenolic compounds, flavonoids, and antioxidant compounds, can be effective on certain pathogenic factors particularly in decreasing cholesterol and blood pressure, preventing an increase in free radicals and ultimately reducing blood clots and vascular resistance to reduce and prevent ischemic disease and its harmful effects. Conclusion: Medicinal plants discussed in this article seem to be able to prevent cardiac damage and the disease progression via affecting the factors that are involved in ischemia

Reversal effect of Achillea millefolium extract on ileum contractions

Introduction: Traditionally Achillea millefolium L. has been used to treat gastrointestinal disorders. In this study the hydroalcoholic extract of A. millefolium was evaluated on ileum contractions of Wistar rats. Materials and Methods: In this experimental study 32 male Wistar rats were designated into 4 equal groups, including: acetyl choline, KCl, extract plus acetyl choline and the group which received extract plus KCl. The isotonic contractions of ileum (induced by 60 mM KCl or 1 μM acetyl choline) in tyrode solution were recorded, under 1 gr tension. Then, the effects of normal saline or extract (1%) were evaluated. The percentage changes were calculated and compared in different groups using ANOWA and Tukey tests. Results: The mean of ileum contractions in acetyl choline and KCl groups were 18.83±4.91 and 18.31±11.12 (p=0.5). The percentage of contraction relieve in extract plus acetyl choline group was 53.16±12.06 and in extract plus KCl group was 62.96±11.08 (p=0.4). The contractions in extract groups were significantly less than acetyl choline or KCl groups (p<0.05). Conclusion: The results indicate that Achillea millefolium extract inhibits ileum contractions. Therefore, it might be used in patients to reduce ileum spasms

Cardioprotective effect of ethanolic leaf extract of Melissa officinalis L against regional ischemia-induced arrhythmia and heart injury after five days of reperfusion in rats

Melissa officinalis has antioxidant and anti-inflammatory activities and is used in various diseases. Aim of the study: We investigated the role of M. officinalis extract (MOE) against ischemia-induced arrhythmias and heart injury after five days of reperfusion in an in-vivo rat model of regional heart ischemia. The leaf extract of M. officinalis was standardized through HPLC analysis. Adult male rats were subjected to 30 min of ischemia by occlusion of the left anterior descending coronary artery followed by 5 days of reperfusion. The rats were randomized to receive vehicle or M. officinalis as follows: group I served as saline control with ischemia, groups II, III and IV received different doses of MOE- (intragastric, 25, 50 or 100 mg/kg respectively), by oral gavage daily for14 days prior to ischemia Administration of M. officinalis significantly improved ischemia/reperfusion (I/R)-induced myocardial dysfunction by reduction of infarct size, episodes of ventricular tachycardia(VT) and ventricular ectopic beat(VEB and duration of VT as compared to control group, stabilized ST segment changes, QTc shortening, increased the R and T wave amplitudes and increased the heart rate during ischemia, increased the serum superoxide dismutase (SOD) activity and decreased serum lactate dehydrogenase (LDH), Troponin I (CTnI) and malondialdehyde (MDA) levels, 5 days after reperfusion. MOE-100mg/kg was the effective dose. Cinamic acid (21.81±1.26 mg/gr) was the main phenolic compound of plant sample. The ethanol extract of M. officinalis was observed to exhibit cardioprotective effects against I/R injury, probably due to antioxidant properties. Keywords Melissa officinalis; Ischemia; Reperfusion injury; Heart; Ra